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  • Title: Real-time ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules.
    Author: Hong Y, Liu X, Li Z, Zhang X, Chen M, Luo Z.
    Journal: J Ultrasound Med; 2009 Jul; 28(7):861-7. PubMed ID: 19546328.
    Abstract:
    OBJECTIVE: The purpose of this study was to evaluate the diagnostic utility of real-time ultrasound elastography in differentiating benign from malignant thyroid nodules. METHODS: A total of 90 consecutive patients with thyroid nodules who were referred for surgical treatment were examined in this prospective study. One hundred forty-five nodules in these patients were examined by B-mode ultrasound, color Doppler ultrasound, and ultrasound elastography. The final diagnosis was obtained from histologic findings. Tissue stiffness on ultrasound elastography was scored from 1 (low stiffness over the entire nodule) to 6 (high stiffness over the entire nodule and surrounding tissue). RESULTS: On real-time ultrasound elastography, 86 of 96 benign nodules (90%) had a score of 1 to 3, whereas 43 of 49 malignant nodules (88%) had a score of 4 to 6 (P <.001), with sensitivity of 88%, specificity of 90%, a positive predictive value of 81%, and a negative predictive value of 93%. The predictivity of ultrasound elastographic measurement was independent of the nodule size. High sensitivity (88%) and specificity (93%) were also observed in 68 nodules that had a greatest diameter of 1 cm or less. CONCLUSIONS: Real-time ultrasound elastography is a promising imaging technique that is useful in the differential diagnosis of thyroid cancer.
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